Chronic hepatitis C virus (HCV) infection is the main cause of cirrhosis and hepatocellular carcinoma and it is estimated that more than 110 million people are chronically infected with HCV worldwide. Efficient antiviral treatment can reduce the risk of developing liver complications, however, poor efficacy and tolerability of current antiviral therapies have limited treatment uptake to <1%.

 

　　This afternoon, Professor Edward Gane from Auckland Clinical Studies Ltd., New Zealand will give a lecture entitled “HCV Therapy-One Treatment for all Populations”.

 

　　With more than 100 direct acting antivirals (DAAs) having entered clinical development, the era of new DAAs has come. Recently, there were three combinations, ledipasvir/ sofosbuvir, ombitasvir (ritonavir-boosted)/paritaprevir plus dasabuvir and elbasvir/grazoprevir, that completed Phase III development that could achieve sustained virological response (SVR) rates >95% in patients with HCV genotype (GT) 1 infection, including cirrhotics and treatment-experienced.

 

　　The oral pangenotypic regimen, sofosbuvir plus pangenotypic NS5A inhibitor velpatasvir for 12 weeks was confirmed to be highly efficient with an SVR of 95-100% in GT 1-6 HCV infected patients in the Phase III ASTRAL studies. Using the next gen NS5A inhibitor ABT-530 plus next gen PI ABT-493 for 8-12 weeks in the Phase II SURVEYOR studies, an SVR of 94-100% could be achieved in patients with HCV GT 1, 2 or 3 chronic infection.

 

　　Now, DAA triplets are being developed to shorten treatment duration and salvage DAA failure patients. In the small Phase II LEPTON study, sofosbuvir/velpatasvir plus the pangenotypic protease inhibitor GS-9857 for 8 weeks could achieve an SVR of 100% in HCV GT1 and GT 3 infected patients with cirrhosis. However, the SVR rates were lower in DAA failures, suggesting that the treatment duration should be prolonged for these patients. In another small Phase II C-CREST study, 8 weeks of grazoprevir plus NUC NS5B inhibitor MK-3682 plus the next gen NS5A inhibitor MK-8508 could achieve an SVR of 92% in patients with HCV GT 1, 2 or 3 infection.

 

　　These pangenotypic and ultrashort regimens represent the final phase of DAA development, with SVR rates above 95% across all patient populations. Combined with DAA access programs, public awareness and community-based targeted testing campaigns, global eradication of HCV should be feasible within the next 50 years.

 

Symposium 3; HCV Treatment in Special Situation - "HCV Therapy-One Treatment for All Populations"

14:55 - 15:15

Room 1ABCD